| NPI | 1013536473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD479411) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301515957) |
| Enumeration Date | 2020-04-15 |
| Last Update Date | 2026-03-20 |